<!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Strict//EN"
  "http://www.w3.org/TR/xhtml1/DTD/xhtml1-strict.dtd">
<html xmlns="http://www.w3.org/1999/xhtml" xml:lang="en">

<head>
  <meta http-equiv="content-type" content="text/html; charset=utf-8"/>
  <title>fcase.com: input a new business</title>
</head>

<body>
  <form action="input.php" method="post">
    <fieldset>
      <legend>Please input a new map place</legend>
      <p>
        <label for="cname">Chinese Name: </label>
        <input name="cname" id="cname" />
      </p>
      <p>
        <label for="ename">English Name: </label>
        <input name="ename" id="ename" />
      </p>
      <p>
        <label for="street">Address: </label>
        <input name="street" id="street" />
      </p>
      <p>
        <label for="suite">Suite: </label>
        <input name="suite" id="suite" />
      </p>
      <p>
        <label for="city">City: </label>
        <input name="city" id="city" />
      </p>
      <p>
        <label for="state">State: </label>
        <input name="state" id="state" />
      </p>
      <p>
        <label for="zip">Zip Code: </label>
        <input name="zip" id="zip" />
      </p>
      <p>
        <label for="phone">Phone Number: </label>
        <input name="phone" id="phone" />
      </p>
      <p>
        <label for="fax">Fax Number: </label>
        <input name="fax" id="fax" />
      </p>
      <p>
        <label for="web">Web: </label>
        <input name="web" id="web" />
      </p>
<!--
      <p>
        <label for="desc">Description: </label>
        <textarea rows="10" cols="60" name="desc" id="desc"></textarea>
      </p>
-->
      <p>
        <input type="submit" value="Submit" />
      </p> 
    </fieldset>
  </form>
</body>

</html>
